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Burden of Maternal and Neonatal Disorser in Nepal from 1990 to 2019; Analysis of Data from Global Burden of Disease Study:An Observational Study
No full textIntroduction: Nepal continues to face significant challenges with high maternal and neonatal mortality. To improve health and achieve the Sustainable Development Goals of reducing maternal and newborn mortality by 2030, Nepal needs to focus on addressing high-burden maternal and neonatal disorders. The objective of the study was to examine the current burden of maternal and neonatal disorders in Nepal and to assess any changes over time. Methods: We examined the annual Global Burden of Disease Study data on prevalence, deaths, Years Lived with Disability, and Disability-Adjusted Life Years for maternal and neonatal disorders in Nepal for the 1990-2019 period. Estimated annual percentage changes were also calculated to assess the trends of the age-standardised rates of these burden metrics. Results: The analysis found that the prevalence of overall maternal disorder in Nepal decreased by 37% from 128,176 in 1990 to 80,724 in 2019 with Age-Standarised Ratio of 432.07 per 100,000 in 2019 and Estimated Annual Percentange Change of-4.34 (CI 95%:-4.49 to-4.18). Similarly, the overall prevalence of neonatal disorder increased by 57% from 303,146 in 1990 to 475,544 in 2019 with Age-Standarised Ratio of 1521.14 per 100,000 in 2019 and Estimated Annual Percentage Change of 0.98 (95% CI: 0.67-1.29). Conclusions: Our findings emphasise the need to address maternal haemorrhage, indirect maternal deaths, maternal abortion and neonatal disorders in Nepal in future national health programs.</p
Measuring the potential for hateful behaviours:development and validation of the Hate Behaviours Scale (HBS)
No full textThis article introduces and reports the psychometric properties of the Hate Behaviours Scale (HBS), which assesses individual intentions to engage in a range of violent and non-violent hateful behaviours against various target groups. Three independent U.S. adult samples (total n = 3524) were used to gather data on the scale and associated covariates and constructs. The twelve-item HBS is comprised of three subscales; Discrimination, Defensive Violence and Belligerent Violence. The higher scores on the HBS were significantly associated with past behaviours such as attending a protest against the target group (β = 0.57, p < .001), having physically hit a member of the target group (β = 0.57, p < .001), and sharing an offensive joke online about the target group (β = 0.51, p < .001). This new measure provides a modifiable, easy to use, reliable and valid multi-component scale for assessing hate against different target groups. It should allow researchers to reliably assess individual levels of hate, and establish relationships with other demographic, social, situational, and psychological characteristics. The HBS provides a short and cost-effective tool to inform and evaluate counter violent extremism interventions aimed at reducing the potential for hateful behaviours.</p
Towards fair decentralized benchmarking of healthcare AI algorithms with the Federated Tumor Segmentation (FeTS) challenge
No full textComputational competitions are the standard for benchmarking medical image analysis algorithms, but they typically use small curated test datasets acquired at a few centers, leaving a gap to the reality of diverse multicentric patient data. To this end, the Federated Tumor Segmentation (FeTS) Challenge represents the paradigm for real-world algorithmic performance evaluation. The FeTS challenge is a competition to benchmark (i) federated learning aggregation algorithms and (ii) state-of-the-art segmentation algorithms, across multiple international sites. Weight aggregation and client selection techniques were compared using a multicentric brain tumor dataset in realistic federated learning simulations, yielding benefits for adaptive weight aggregation, and efficiency gains through client sampling. Quantitative performance evaluation of state-of-the-art segmentation algorithms on data distributed internationally across 32 institutions yielded good generalization on average, albeit the worst-case performance revealed data-specific modes of failure. Similar multi-site setups can help validate the real-world utility of healthcare AI algorithms in the future.</p
ChatGPT in Education:An Effect in Search of a Cause
No full textBackground: As researchers rush to investigate the potential of AI tools like ChatGPT to enhance learning, well-documented pitfalls threaten the validity of this emerging research. Issues of media comparison research, where the confounding of instructional methods and technological affordances is unrecognised, may render effects uninterpretable. Objectives: Using a recent meta-analysis by Deng et al. (Computers & Education, 227, 105224) as an example, we revisit key insights from the media/methods debate to highlight recurring conceptual challenges in ChatGPT efficacy studies. Methods: This conceptual article contrasts nascent ChatGPT research with the more established literature on Intelligent Tutoring Systems to identify three non-negotiable considerations for interpretable effects: (1) descriptions of the precise nature of the experimental treatment and (2) the activities of the control group, as well as (3) outcome measures as valid indicators of learning. To provide some initial evidence, we audited a subset of primary experiments included in Deng et al.'s meta-analysis, demonstrating that only a small minority of studies satisfied all three non-negotiable considerations. Results and Conclusions: Loosely defined treatments, mismatched or opaque controls, and outcome measures with unclear links to durable learning obscure causal claims of this emerging literature. Observed gains cannot, at this time, be confidently attributed to ChatGPT, and meta-analytics effect sizes may over- or understate its benefits. Progress, we argue, will require rigorous designs, transparent reporting, and a critical stance toward “fast science.”.</p
Reconsidering the use of oral exams and assessments:an old way to move into a new future
No full textThe arrival of ChatGPT and other artificial intelligence (AI) has caused considerable concern for educators worldwide, many of whom are still recovering from the impact of the COVID-19 pandemic. Although the debate continues around the use of AI in education, one approach to ensure students are achieving their learning objectives, the oral exam or assessment, is gaining renewed interest. This article covers the background of oral exams and assessments, types, benefits, challenges, practical considerations, and recommendations. The oral exam or assessment is not only a vehicle to reduce academic integrity issues but is an authentic assessment offering educators and students a range of benefits: mirroring professional practice and increasing student communication skills, confidence, and a deeper understanding.</p
Fertility care in low- and middle-income countries:Training in assisted reproduction in South Africa
No full textAbstract: Intending parents on the African continent have limited access to quality services for infertility treatment. South Africa is the primary provider of fertility care on the continent, but because specialist training is only available in three public (teaching) hospitals, supported through partnerships with private institutions, there is a shortage of medical staff and waiting times for admission to training programmes can be years. We draw on data from our qualitative research study on assisted reproduction, generated from clinic visits, informal interviews, participation in science meetings, and formal interviews with 117 patients, gamete donors, clinicians, reproductive scientists and others to explore access to and motivation for training. Trainees' reasons for embarking on this specialisation included: concern with limited access to gynaecological and fertility care on the continent; lack of skilled fertility specialists and embryologists; and lack of options for assisted reproduction available to low-income intending parents. Trainee fellows expressed commitment to low-cost IVF models to address the lack of affordable and accessible reproductive health care. Fertility specialists often shared this concern and emphasised the need for trained professionals to expand services. In general, interviewees felt that infertility care and assisted reproduction were regarded as of lesser importance to other reproductive and health problems, despite the extent of infertility and the demand for assisted reproduction technology (ART) on the continent. Lay summary: Countries across the African continent have the highest infertility rate in the world, yet access to diagnosis of cause, treatment and assisted reproductive technology is sparse. Assisted reproduction clinics now operate in several countries, particularly Ghana, Nigeria, Kenya and South Africa. Most support is in the private health system, and few women and men have access to low-cost assisted reproduction services at public hospitals. While clinics, biobanking services and laboratories are sparse, so too is training. We draw on data from a large study on assisted reproduction in South Africa to explore the provision of training. Most training is provided in South Africa, and people from other countries can access this. However, few teaching hospitals provide training, and people face long delays, sometimes years, before they can enrol. The limited opportunities for training seriously impact the capacity of countries to meet the health needs and support the reproductive hopes of many of their populations.</p
Influence of Clinical Risk Factors on International Normalized Ratio Control in Patients on Warfarin Therapy:A Systematic Review
No full textWarfarin remains a widely prescribed oral anticoagulant despite its narrow therapeutic index and its association with life-threatening bleeding events. This systematic review examined the impact of clinical risk factors on international normalized ratio (INR) control in patients receiving Warfarin therapy. Following the PRISMA-P guidelines, we searched four electronic databases (PubMed, SCOPUS, Embase, and Web of Science) using Medical Subject Headings to identify eligible cohort studies published between 2016 and 2020. A total of 15 original research articles met the inclusion criteria. The risk of bias was assessed using the Newcastle-Ottawa scale. This review identified several clinical risk factors influencing INR control, including drug interactions with Warfarin, herbal supplements, dietary intake of vitamin K, and multiple comorbidities (anemia, heart failure, chronic kidney disease, psychiatric disorders, prosthetic valve), kidney transplant recipient, hemodialysis, and hypoalbuminemia. These clinical risk factors adversely affect the time in therapeutic range, thereby increasing the risk of adverse outcomes such as thromboembolism, major bleeding, and mortality. Overall, these clinical risk factors compromise Warfarin efficacy by contributing to subtherapeutic or supratherapeutic INR levels. Identifying and addressing these clinical risk factors prior to initiating Warfarin therapy is essential to achieving optimal INR control
Ethical coaching and athlete transitions:a Foucauldian perspective on high-performance sports
No full textHigh-performance sport is often celebrated for cultivating discipline, resilience and excellence. Yet, the same structures that produce elite performance frequently rely on disciplinary practices that can compromise athlete autonomy, well-being and identity development. This article interrogates the ethical dimensions of coaching in high-performance sport through a Foucauldian lens, drawing on concepts such as disciplinary power, technologies of the self and the aesthetics of existence. Building on the work of Jim Denison and colleagues, as well as our own previous work, we examine how coaching practices shape athlete subjectivities both during and after elite sporting careers. The paper presents a framework that coheres a number of key concepts from existing coaching research and enriches them through a Foucauldian ethical perspective, offering a unified way of understanding the ethical dimensions of coaching. We argue that coaching must be reimagined as an ethical, relational and reflexive practice that goes beyond harm reduction to actively support athlete well-being and meaningful, sustainable transitions beyond sport. We explore how ethical self-creation can enable coaches to resist dominant norms and develop care-based coaching approaches that challenge the performance-at-all-costs ethos. We also consider how these insights align and contrast with existing youth sport philosophies and conclude by proposing a set of guiding principles for fostering ethical and sustainable coaching environments. In doing so, the paper offers a contribution to sport coaching research and practice by illuminating how coaches can engage in ethical self-work and systemic transformation, positioning athletes not only as performers but as whole persons capable of living meaningful lives in and beyond sport
